Provider Demographics
NPI:1760814768
Name:DRAYER PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:4790 RED BANK EXPRESSWAY
Mailing Address - Street 2:SUITE 128
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1598
Mailing Address - Country:US
Mailing Address - Phone:513-252-0533
Mailing Address - Fax:513-252-0534
Practice Address - Street 1:4790 RED BANK EXPRESSWAY
Practice Address - Street 2:SUITE 128
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1598
Practice Address - Country:US
Practice Address - Phone:513-252-0533
Practice Address - Fax:513-252-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty